Washington For industry players hoping for a favorable General Accounting Office report on the durable medical equipment regional carriers' inherent reasonableness authority, here are two words for you: Keep dreaming.

According to its report released in July, the GAO supports the process used by the Health Care Financing Administration in implementing IR authority and, consequently, supports the DMERCs' implementation of IR reductions without HCFA's consent. Further, the GAO said, it supports the DMERCs' authority to circumvent notice-and-comment requirements and their authority to implement IR reductions with no more than a 30-day notice in supplier bulletins.

The GAO did, however, urge HCFA and the DMERCs to develop a standard survey to guide the IR data collection process. It also noted that the DMERCs had failed to gather enough pertinent data to support reductions for blood glucose strips, category one enteral or albuterol sulfate. And it did agree with the industry stance that using retail prices for oral nutritional supplements to set Medicare reimbursement was not appropriate.

HCFA administrator Nancy-Ann DeParle said HCFA plans soon to issue a final rule implementing IR authority, which also will include reductions in Medicare reimbursement for foley catheters, catheter insertion trays, eyeglass frames and lancets. That will reduce reimbursement $8 million over five years. Also, officials said, HCFA plans to move forward with the reductions proposed in August 1999-for walkers, commode chairs, transcutaneous electrical nerve stimulator units and vacuum erection devices-thus lowering Medicare reimbursement by another $120 million over five years.

The full IR report can be found on the GAO's Web site at www.gao.gov.